Archive for stress

If you have a conscientious doctor, you’ve probably been asked important health questions such as:

Are you eating a mostly vegetable based diet?

Are you avoiding sugar and limiting glucose-spiking carbohydrates like white pasta and bread?

Are you choosing organic?

Are you avoiding habits that can harm your health, such as cigarette smoking, excessive alcohol intake, and drinking too much caffeine?

Are you exercising regularly?

Do you get enough sleep?

If your doctor is particularly hip, you may have also been asked about your stress levels and what you’re doing to keep your stress under control. But is your doctor helping you understand what stress really is? You may think it’s all about how long your “to do” list is, but you may not realize what stress is to your body.

What Is Stress?

As I wrote about in Mind Over Medicine: Scientific Proof That You Can Heal Yourself, as far as your nervous system is concerned, stress is anything that triggers the amygdala in your primordial limbic system to activate the “fight-or-flight” stress response. And whenever this happens, your body’s natural self-repair mechanisms- the ones that help prevent heart disease, fight cancer, ward off infection, and assist in anti-aging- get flipped off. As far as your body’s health is concerned, thoughts, beliefs, and feelings that trigger the stress response may damage your health more than a poor diet, avoiding exercise, bad habits, and sleep deprivation.
But the good news is that the opposite is also true! Because your thoughts, beliefs, and feelings are at least partially under your control, you have the power to switch off your body’s stress responses and return the nervous system to the health-inducing relaxation response that activates the body’s natural self repair.
So which questions should your doctor be asking? Which ones should you be asking yourself? Check out the following questions which assess your “whole health” and which all have been scientifically proven to affect your health and longevity.

Take The Whole Health Quiz

While I was in Fargo, North Dakota delivering my third TEDx talk (you can watch my other two here and here, I facilitated a community conversation about health care with Dr. Susan Mathison, founder of Catalyst Medical Center, who is also one of the doctors in my Whole Health Medicine Institute training program. The brunch was filled with doctors, nurses, energy healers, chiropractors, and empowered patients, and many of them have beefs against each other. You could feel the tension in the room, but you could also feel the capacity for love, for connection, for a long overdue bridge.
In the middle of the event, I had a massive epiphany (yet another in a week filled with painful but necessary epiphanies that are helping me refine my message and get clear on my role in healing health care.)
Here’s what I realized.

Doctors Are Traumatized

As doctors, we are traumatized by our training, the limitations of the health care system, and the very nature of what it means to be a doctor- to be on the front line of a lot of suffering- death, disease, disability, despair. We’ve had to come to work sick, we’ve skipped our postpartum leave and left our babies, we’ve had bloody scalpels thrown at us by physician professors who curse at us, and we’ve stayed awake to help others in 72 hour shifts. We’ve witnessed the deaths of children, dismemberment, and patients who die when we did everything we could to save them. We’ve gone through a hazing worse than any fraternity and similar to what soldiers experience. Yet people expect soldiers to have PTSD, but not doctors.
Having gone through all this, as doctors, it’s easy to get frustrated with the entitlement of patients and the disrespect of alternative health care providers who dismiss the often life-saving work we do, who don’t appreciate the sacrifices we make in order to do this life-saving work. Doctors feel unappreciated, devalued, and disenfranchised by a fractured system that has robbed them of much of the joy of their work, and that only amplifies the trauma.
Yet, as doctors, we tend to normalize the trauma. Every doctor we know has been through the fire, so we just think it’s an unavoidable part of the job. We think it’s our job to just buck up and keep going, not realizing that by failing to acknowledge the trauma and recover from it, by shutting down and closing our hearts, we are losing the very part of us that makes us good doctors.
Some doctors have done a great deal of difficult personal growth work to heal from the trauma of our profession. But most doctors are blind to the fact that they have experienced profound trauma. Those doctors don’t even realize they may be perpetuating more trauma because of their own unhealed trauma.

Nurses And Other Health Care Providers Are Traumatized

The nurses, nurse practitioners, physician assistants, midwives, and other health care providers who report to doctors are often traumatized by the doctors, who are so exhausted and traumatized and overworked that those who help them care for patients often bear the brunt of their misplaced anger. Psychologists call it “sublimation,” a defense mechanism whereby you suppress a socially inappropriate impulse and replace it with a substitute you deem to be more socially acceptable. (Your boss yells at you, and you’re not allowed to yell back, so you come home and kick the dog.)
But nurses are not dogs paid to get kicked by traumatized doctors who haven’t healed themselves. Nurses and physician extenders are healers in their own right, and when it comes to the art of true healing, they often practice it better than doctors.

Alternative Medicine Practitioners Are Traumatized

Recently, I was blessed to be able to spend an hour on the phone with my shero and mentor Brené Brown, author of the #1 New York Times bestseller Daring Greatly. We had so much giddy fun on our teleclass about the intersection of vulnerability and health, how shame is lethal, and how daring greatly and practicing mind over medicine helps you heal. (If you missed the live call, you can get the free download here.)
I had an epiphany during our call that I want to share with you, so pull out your big highlighter. Brené says the most terrifying emotion we experience as humans is joy. We're so frightened of loss that we can't even allow ourselves to lean into those moments when we're standing over our children watching them sleep or when we're falling in love and it feels like our hearts will burst. The second most of us start to feel joy, instead of relishing the blessings, we tend to get swallowed by the fear that the other shoe is about to drop.

Foreboding Joy

Brené said, “When we lose our tolerance for vulnerability, joy becomes foreboding." Instead of allowing ourselves to feel the vulnerability of how much joy we feel and how much hurt we would experience if we lost what we have, we dress rehearse tragedy so we can beat vulnerability to the punch. We look at our kids with so much love and then imagine them dying. We feel such tenderness for the person we're falling in love with that we fast forward straight to the day when we get our heart broken. If things are going well in our professional life, we imagine the day we get fired or lose all our money, power, and status. It's like, by trying to imagine the worst case scenario, we somehow think we're protecting ourselves from what we fear most.
But guess what? It doesn't work. If your child dies or the love of your life abandons you or you lose your job or you declare bankruptcy - or whatever tragedy you imagine might befall you happens - no dress rehearsal will protect you from loss and pain. And in the interim, you've missed your chance for effervescent joy, radical presence, true bliss - and the health benefits that accompany joy.

Dress Rehearsing Tragedy

As I headed to Albany, New York last week to film a 90 minute public television special, as well as 6 hours of additional DVD content that would be included as part of the PBS fundraising pledge package, I knew I was walking into a situation that was completely out of my comfort zone. I so wanted to feel like I was going to just nail it on that television set, that I would get it all perfectly right on my first try, that I would wow everyone with my professionalism and TV chops, that everyone would come to me later and say, “Lissa, you’re a natural!”
So I loaded myself up with expectations, hoping I’d get it right, wanting to impress my producers and please my publisher and all that jazz. Naturally, heaping myself with expectations of perfection only left me feeling stressed and overwhelmed in the months before the film date. And then, suddenly, I was backstage, about to appear before a live studio audience to deliver what I hoped would be a perfect performance. (No biggie.)

Permission To Be Imperfect

Suddenly, inside my head, I heard the soothing voice of Brené Brown (with whom I just did a free teleclass - you can listen to us here). When Brené was about to appear on Oprah’s Super Soul Sunday, she wrote herself a permission slip, which she hid in her pocket. The permission slip said, “Permission to be imperfect.” So right there, back in the wings, I wrote myself the same permission slip, and when I stood in front of that studio audience, I told everyone to bear with me because I was about to give an imperfect performance.
I then proceeded to royally flub up several times, stuttering over my words and misreading the teleprompter. Fortunately, the special was prerecorded! All I had to do when I screwed up was stop, admit my mistake, and try again. The audience had even been prepped so that if I said the same thing twice, they were supposed to pretend they were hearing my hopefully wise words for the very first time!

What If Life Had “Do Overs?”

After a few mistakes and do overs, I said to the audience, “Wouldn’t life be great if we were allowed to just pause and get a ‘Do over’ in other aspects of our life?” And then I realized I’ve done just that. I married imperfectly - twice - and I’ve now been with husband #3 for almost eleven years. (Do over! Do over!) I wound up unhappy in my job as a practicing physician, so I went through a massive career change. (Do over!) My health broke down because I wasn’t caring for my body or my mind, but I was blessed to get a do over in my health and am now down to half the dose of one of the seven medications I was once taking.
I have been pausing, admitting my mistakes, and doing life over again time after time! And this, I’m realizing, is one of the essential keys to a happy life.

The Pressure Of Perfection

You probably know that having a toxic job that stresses you out and sucks the soul out of you isn’t exactly good for you. As a physician who has experienced work stress myself, as well as witnessing it in my patients, it’s obvious to me that work stress is poisonous and can translate into physical symptoms. You know this already. Anyone who has ever gotten a migraine after a deal went bad or stiff shoulders after the boss criticized him can attest to that.
But did you realize that work stress can actually kill you?
In Japan, they even have a word for it - karoshi - which is defined as “death by overwork.” Karoshi usually happens to relatively young, otherwise healthy people who are burning the candle at both ends in a less-than-dreamy work environment.
The first case of karoshi was reported in 1969, when a worker died of a stroke at the age of 29. But it wasn’t until 1987 that the Japan Ministry of Labor began collecting statistics on karoshi. Since that time, Japanese officials estimate that approximately 10,000 cases of karoshi occur each year.
This should be big news! Some lawyers and scholars even claim that the number of karoshi deaths in Japan equals or exceeds the number of traffic accident fatalities each year. But when was the last time your doctor added “Alleviate work stress” to your preventive maintenance or treatment plan?

What Happens Physiologically When People Die of Karoshi?

Karoshi is not a single disease. It’s a constellation of what are believed to be stress-induced physiological changes that usually lead to either sudden cardiac death or stroke, most likely caused by repetitive triggering of the “fight-or-flight” stress response that activates the sympathetic nervous system, raises blood pressure and heart rate, and overstresses the cardiovascular system.
Just before dying, most karoshi victims complain of varying combinations of dizziness, nausea, severe headache and stomach ache. In 95% of karoshi cases, death occurs within 24 hours of the onset of severe symptoms, though milder symptoms sometimes precede the severe ones. (If you’re stressed at work, do any of these symptoms sound familiar to you? If so, listen up. That’s your body telling you your work could be harming your health.)